First Name *

Last Name *

Pronouns *

Email Address *
Please enter a GVSU student email address ending in @mail.gvsu.edu.

Email Address (Confirmation) *

Phone *

Year at GVSU *
- Select Option Freshman Sophomore Junior Senior Graduate Student

Would you consider yourself a non-traditional student? *
Yes
No
Not sure

If you answered yes to the previous question, please explain your nontraditional status (to the extent to which you are comfortable).

A nontraditional student is typically defined as someone who has multiple roles in addition to being a student, such as someone who is: a full-time employee, a spouse/partner, a parent, over 23 years old, a veteran, or someone returning to a learning environment after a long absence (3+ years away).

Please consider this definition and reconsider your answer to the previous question.

Race/Ethnicity (if comfortable sharing)

Gender Identity (if comfortable sharing)

Sexual Orientation (if comfortable sharing)

Religious, secular, or spiritual identity/tradition (if comfortable sharing)

Are you an international student? *
Yes
No

Country

What if any role does your worldview identity (whether religious or not) play in your day-to-day life? *

What hopes do you have for this program? *

Please provide a brief story about a time when you were surprised by someone or when you learned something new about a friend. *

Do you have a smartphone with a camera? *
Yes
No

If you are selected for this cohort, we will work with our Photovoice partners to make sure a digital camera will be made available for your use.